Editors note: Neuroscientists at the University of Birmingham have identified biomarkers that can indicate whether the brain has suffered injury after an accident. Due of this discovery, doctors will now be able to quickly diagnose & reduce secondary brain damage at an early time.
Motivation behind the research
Traumatic brain injury (TBI) is the leading cause of death and disability among young adults and, according to the World Health Organization, by 2020 TBI will become the world’s leading cause of neurological disability across all age groups.
Early and correct diagnosis of traumatic brain injury is one of the most challenging aspects faced by clinicians. Being able to detect compounds in the blood that help to determine how severe is the brain injury, this would be of great benefit to patients and aid in their treatment. Inflammatory markers are particularly suited for biomarker discovery as TBI leads to very early alterations in inflammatory proteins. The discovery of reliable biomarkers for the management of TBI would improve clinical interventions.
We collected blood samples from 30 injured patients within the first hour of injury prior to the patient arriving at hospital and analysed them. Analysis of blood taken within the first hour of injury has never been carried out until now. We used a panel of 92 inflammation-associated human proteins when analysing the blood samples. The analysis identified three inflammatory proteins, known as CST5, AXIN1 and TRAIL, as novel biomarkers of TBI.
This study is based on data from 30 patients; further cohorts of patients would be useful to increase the sample size and validate our findings.
Early pre-hospital detection of TBI would support clinical decision-making and the correct triage of major trauma. Moreover, the correct diagnosis of TBI, which is one of hardest diagnosis to make in medicine, would allow clinicians to implement strategies to reduce secondary brain injury at an early stage, for example, by optimising blood and oxygen delivery to the brain and avoiding manoeuvres that could potentially increase intracranial pressure.
Intracranial pressure is the pressure inside the skull and thus in the brain tissues.
In addition, this discovery has potential implications for drug development. Novel compounds could be given immediately after the injury (e.g. roadside accident) if there was sufficient confidence in the diagnosis of TBI.
Research article: Cystatin D (CST5): An ultra-early inflammatory biomarker of traumatic brain injury. Scientific Reports. DOI: nature.com/articles/s41598-017-04722-5
Scientists Bio Dr Lisa Hill is a Research Fellow in Neuroscience and Ophthalmology at the University of Birmingham, UK. In addition to science, Lisa loves to travel and is obsessed with Game of Thrones and her 3 big Labradors. Dr Valentina Di Pietro is a molecular Neuroscientist from Neuroscience and Ophthalmology at the University of Birmingham, UK. Professor Antonio Belli is the Director of the NIHR SRMRC, Professor of Trauma Neurosurgery at the University of Birmingham and Consultant Neurosurgeon at the Queen Elizabeth Hospital Birmingham. This study was funded by NIHR SRMRC.
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